Accuracy of a bedside dysphagia screening: a comparison of registered nurses and speech therapists

Rehabil Nurs. 2008 Nov-Dec;33(6):247-52. doi: 10.1002/j.2048-7940.2008.tb00236.x.

Abstract

Evidence-based guidelines suggest that stroke patients should be screened for dysphagia before oral intake. The purpose of this study was to validate a dysphagia screening tool comparing registered nurses (RNs) with speech therapists (STs). All stroke unit patients who received predetermined scores on specific items of the National Institutes of Health Stroke Scale were eligible for screening. The trial consisted of three parts (with swallow, cough, and vocal quality observed during each part): 1 teaspoon lemon ice, 1 teaspoon applesauce, and 1 teaspoon water RNs performed five screenings that were compared with independent screenings performed on the same patient within 1 hour by a speech therapist (ST). Eighty-three paired screenings were completed, with 94% agreement between the RNs and the STs. This screening identifies patients who are able to swallow and can eat from a safe menu until formally evaluated by an ST while maintaining nothing by mouth (NPO) status for those at risk for aspiration.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Clinical Competence
  • Clinical Protocols / standards
  • Deglutition Disorders / diagnosis*
  • Deglutition Disorders / etiology
  • Education, Nursing, Continuing
  • Evidence-Based Nursing
  • Hospital Units
  • Humans
  • Mass Screening / methods*
  • Mass Screening / standards
  • Nursing Assessment / methods*
  • Nursing Assessment / standards
  • Nursing Evaluation Research
  • Nursing Staff, Hospital / education
  • Observer Variation
  • Point-of-Care Systems
  • Practice Guidelines as Topic
  • Respiratory Aspiration / etiology
  • Respiratory Aspiration / prevention & control
  • Risk Assessment
  • Speech Therapy / methods*
  • Speech Therapy / standards
  • Stroke / complications